Abstract
BackgroundCardiorespiratory arrests are rare in paediatric intensive care units, yet intensive care nurses must be able to initiate resuscitation before medical assistance is available. For resuscitation to be successful, instant decision-making, team communication, and the coordinating role of the first responsible nurse are crucial. In-house resuscitation training for nurses includes technical and nontechnical skills. ObjectivesThe aim of this study was to develop a valid, reliable, and feasible assessment instrument, called the Professional Assessment Tool for Team Improvement, for the first responsible nurse's technical and nontechnical skills. MethodsInstrument development followed the COnsensus-based Standards for the selection of health Measurement Instruments guidelines and professionals' expertise. To establish content validity, experts reached consensus via group discussions about the content and the operationalisation of this team role. The instrument was tested using two resuscitation assessment scenarios. Inter-rater reliability was established by assessing 71 nurses in live scenario sessions and videotaped sessions, using intraclass correlation coefficients and Cohen's kappa. Internal consistency for the total instrument was established using Cronbach's alpha. Construct validity was assessed by examining the associations between raters' assessments and nurses' self-assessment scores. ResultsThe final instrument included 12 items, divided into four categories: Team role, Teamwork and communication, Technical skills, and Reporting. Intraclass correlation coefficients were good in both live and videotaped sessions (0.78–0.87). Cronbach's alpha was stable around 0.84. Feasibility was approved (assessment time reduced by >30%). ConclusionsThe Professional Assessment Tool for Team Improvement appears to be a promising valid and reliable instrument to assess both technical and nontechnical skills of the first responsible paediatric intensive care unit nurse. The ability of the instrument to detect change over time (i.e., improvement of skills after training) needs to be established.
Highlights
Cardiorespiratory arrests are rare in paediatric intensive care units, yet intensive care nurses must be able to initiate resuscitation before medical assistance is available
To the yearly mandatory APLS training,[42] the paediatric intensive care unit (PICU) nurses made clear that regular assessments in teamwork training would make them feel confident about their technical and nontechnical skills
We aimed to develop and test the validity, reliability, and internal consistency of the Professional Assessment Tool for Team Improvement (PATTI©) that assesses technical and nontechnical skills of nurses in the PICU
Summary
Cardiorespiratory arrests are rare in paediatric intensive care units, yet intensive care nurses must be able to initiate resuscitation before medical assistance is available. Objectives: The aim of this study was to develop a valid, reliable, and feasible assessment instrument, called the Professional Assessment Tool for Team Improvement, for the first responsible nurse's technical and nontechnical skills. Conclusions: The Professional Assessment Tool for Team Improvement appears to be a promising valid and reliable instrument to assess both technical and nontechnical skills of the first responsible paediatric intensive care unit nurse. The literature confirms that simulation is an effective method of training resuscitation teams in teamwork skills.39e41 During the debriefing in the team training sessions, our nursing staff suggested that technical and teamwork skills should be regularly assessed. They indicated the discrepancies between regular assessment during their formal training and the lack thereof after finishing education. To the yearly mandatory APLS training,[42] the PICU nurses made clear that regular assessments in teamwork training would make them feel confident about their technical and nontechnical skills
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